Effects of a Dyadic Music Therapy Intervention on Parent-Child Interaction, Parent Stress, and Parent-Child Relationship in Families with Emotionally Neglected Children: A Randomized Controlled Trial
Reviewed by Florencia Rusinol, music therapy intern
The purpose of this research article was to explore the effects of dyadic music therapy intervention on parent-child interaction, parenting stress, and parent-child relationship in families with emotionally neglected children and families at risk. This study was conducted in a residential family care center in Denmark. Eighteen parent-child dyads were recruited secondary to several criteria, such as 5-12-year-old children with no developmental deficits or diagnoses, parents that exhibit evidences of emotional neglect, and other exclusion criteria. The dyads were randomly assigned to the two groups, experimental, music therapy, and control, treatment as usual. Psychological and pedagogical support comprised the treatment as usual, with guidance on structure, communication, and other parenting strategies. The psychological visits were focused on general development of the children and well being of the parent.
The researchers used both observational and parent self-report measures for data collection. The music therapists conducted video-recorded, specialized assessment sessions called Assessment of Parenting Competences (APC) session. Each dyad underwent to of those sessions as well as self-report questionnaires called the Parenting Stress Index (PSI) and the Parent-Child Relationship Inventory (PCRI). The dyads then participated in 6-10 music therapy sessions, once a week, for 45-50 minutes. The participants completed the same APC assessment sessions and self-report questionnaires four months after the initial assessments.
The authors did not mention any specific template for how the music therapy sessions were conducted other than it being partially client-centered and partially therapist-directed. The only specific intervention mentioned was musical improvisation. The authors mention having formulated goals, interventions, and techniques, but did not include them in the article.
The results of this study showed that music therapy had a significant and positive effect on parental competencies and parent-child interactions, especially in the mutual attunement between the dyad, nonverbal communication, and parent-child interaction. The music therapy group dyads showed a significant effect on parent-to-child communication, particularly in the level of empathy. Lastly, there was a significant decrease from both groups in how stressful the parents perceive the child to be, and how stressful the relationship in general was to the parents.
This article leaves the reader with several questions. For example, after reading the article I am confused as to whether both groups received treatment as usual or just the control group. At the beginning of the article, the authors state that the dyads in “the experimental group and the treatment as usual group both received treatment as usual at the family care center,” (Jacobsen, McKinney, & Holck, 2014). However, in the “Recommendations for Future Research” section, it was recommended that both groups receive treatment as usual and a second condition. Furthermore, is it valid to compare the two groups if the experimental group is receiving two treatments and the control group is only receiving one? And what influences does the treatment as usual have on the additional treatment of music therapy?
Among this study’s strengths were that this study employed the successful tools to measure outcomes, for the most part (there were a few sections of the PCRI that the authors mention may not have been relevant for this study). Also, there were two blind randomizations involved in placing the dyads into the experimental or control groups. I believe it is a strength that this study was conducted internationally, in Denmark, with a cross-cultural collaboration (co-authored by an Appalachian State University professor). Lastly, the authors clearly denoted some of the limitations of this study, such as potential bias from one of the researchers being a treating music therapist in the study and that not all of the families having received the total number of sessions.
Some recommendations that I have for future research stemming from this article are, first, a larger sample size to make it further generalizable. Second, I recommend a clearer control group, i.e. one group received treatment as usual and one group received music therapy to truly compare the effects of this modality. Lastly, incorporating more non-music therapists into the research may help validate the research more in other medical disciplines.
Jacobsen, S. L., McKinney, C. H., & Holck, U. (2014). Effects of a dyadic music therapy intervention on parent-child interaction, parent stress, and parent-child relationship in families with emotionally neglected children: A randomized controlled trial. Journal of Music Therapy, 51(4), 310-332. doi: 10.1093/jmt/thu028